How Would a Supreme Court Reversal on Roe v. Wade Affect California?

How much could President Trump's U.S. Supreme Court nominee, Brett Kavanaugh, change health care in California?

Supporters of reproductive rights have been fearful -- and abortion opponents have been hopeful -- that any Trump nominee would work with the court's other conservative justices to overturn Roe v. Wade. That landmark 1973 decision legalized abortion across the country. But in legal terms, a Roe reversal would merely push the decision back to the states.

Analysts estimate 22 states would immediately or quickly ban abortion if that occurred -- but California is not one of them.

Rather, it's one of nine states that have specifically put a law on the books codifying a woman's right to choose abortion.

But that doesn't mean patient rights and the practice of health care wouldn't change in California, warns Crystal Strait, CEO of Planned Parenthood Affiliates of California. There are many other ways Kavanaugh's confirmation could affect what doctors and patients can do, Strait says.

“California is not an island. If something happens to women around the country, then that impacts California just as much. I think we have to be really cautious," Strait told KQED, just minutes after Trump announced his pick Monday evening.

Hypothetically, a Supreme Court decision could legally redefine the meaning and scope of abortion, which would have a trickle-down effect, even on states like California that want to keep abortion legal.

"So they could put undue burden [on a woman], they could put new rules and regulations through a Supreme Court decision and then obviously someone in California would sue, and we'd re-litigate that up to the Supreme Court," Strait explained. "But since the Supreme Court would have just decided that case, it's hard to imagine -- right? -- that they would undo themselves."

But there are other, more indirect ways that reproductive rights and medical practice could be restricted under a future Supreme Court, even in California, Strait explained.

One example would be “gag rules” on women’s health clinics, including Planned Parenthood. (These are not to be confused with a recent Supreme Court ruling, freeing "pregnancy crisis centers" from the strictures of a California state law).

Rather, what Strait calls a "gag rule" refers to a recent Trump proposal that would make all clinics that accept federal Title X funds -- which pay for STD tests, cancer screenings and contraception for low-income women -- obey new restrictions on how doctors can discuss abortion with their patients.

If a future Supreme Court upheld such a rule, Strait said, that might in turn lead to other restrictions on what doctors can say.

“Imagine you're going to talk to your doctor and you want to figure all your options and your doctor literally is gagged. They literally are not allowed by law to tell you what your medical options are. And that is just, I think, a really frightening place to be and to think about."

Kavanaugh's addition to the court could also affect the Affordable Care Act -- which has built-in protections for patients with pre-existing conditions -- and for insurance coverage of contraception.

In the past, Kavanaugh has sided with employers who don’t want to include birth control in their health plans. Strait said any change to provision of the law would affect millions of California women, and their wallets.